This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Children with major burn injuries have increased energy needs for their healing bodies for up to one year post burn. During this hypermetabolic state they waste fat and muscle tissue and stop producing new bone. This can diminish their normal growth of childhood, leave them in a weakened state and prevent them from proper rehabilitation and reintegration back into society. We hypothesize that the use of a structured exercise training program and the use of anabolic drugs will decrease the hypermetabolic state following burn injury and quicken rehabilitation. A hypermetabolic state continues in burned children through the first year post burn causing muscle wasting, weakness, bone loss, decreased growth, decreased ability to fight infection, and increased scarring. We hypothesize that by separate basic mechanisms, these catabolic-hypermetabolic responses may be ameliorated by therapeutic use of o An exercise program o Oxandrolone o Propranolol o Ketoconazole Patients will be various groups of exercise and drugs beginning at 5 days after the first operation. Patients will be assessed at specific time intervals with a variety of tests and measurements (discharge, 6, 9, 12, 18, 24 months post burn). At the end of the study the groups will be compared to each other. This study will have significant implications to improve treatment following a severe burn injury. It will provide information that may lead to improved methods of clinical care that will improve and hasten the recovery process.